UCLA SCHOOL OF PUBLIC HEALTH COMMUNITY HEALTH SCIENCES Fall 2009 CHS 440

Transcription

1 UCLA SCHOOL OF PUBLIC HEALTH COMMUNITY HEALTH SCIENCES CHS 440 COURSE TITLE: Public Health and National Security at the U.S.-Mexico Border INSTRUCTORS: Samuel J. Stratton, MD, MPH Adjunct Professor Dept of Community Health Sciences UCLA School of Public Health Office: (310) Cell Phone: (714) FAX: (310) Rick Greenwood, PhD, MPH Office: (626) Adjunct Professor Department of Epidemiology UCLA School of Public Health UNITS: PREREQUISITES: FORMAT: TIME: Two Graduate Standing One two-hour session per week. Sessions consist of didactic lectures and structured class discussions based on case studies. Each student will present one literature review item during the course. A final paper of no more than 10 pages (double spaced) will be due during final exam week. Mondays 10 am -12 pm LOCATION: SPH COURSE OBJECTIVES Understand the concepts of borders and the common definitions and legal principles that exist with boundaries we call borders. Understand the public health challenges that exist when borders separate populations of differing cultures and economic status. Appreciate the differences in health care delivery methods and goals that exist across the US- Mexico Border Understand the risks and difficulties that exist at the US-Mexico Border with regard to national security and terrorist activity Appreciate the public health issues that center on free trade and mutual cooperation between nations at borders

2 Page 2 TEXTBOOKS Suggested: Puro Border, LH Crosthwaite, JW Byrd, B Byrd (eds), Cinco Puntos Press, 2003 COURSE READINGS Monographs and articles will be distributed in electronic format during the course. These articles will provide background and an introduction to topics presented in each session. It is important that relevant reading material be reviewed prior to each session. Because of limited contact time in the classroom, lectures and discussions will develop upon the readings for that session. If you are unable to attend a class, readings are provided electronically so that you can prepare for upcoming sessions. COURSE REQUIREMENTS AND GRADING Course grade is by letter only. The grade will be based on a literature review presentation and final written reports. Attendance is expected at each class session, if you cannot attend a session; please contact the instructor for a possible excused absence. Final grades will be based on the following breakdown: 1. Literature review presentation 20% Each student is expected to present a 10 to 15 minute discussion of an article or paper related to border health and security. Discussion material may be obtained from the scientific literature, current printed news sources, or the Internet. Students should be prepared to relate their selected article to the topic of border health and security and should present a critical analysis of the concepts and conclusions presented in the reference article. Also, the applicability of the article to the field of public health should be discussed. At the first class session, specific elements expected of the presentations will be presented and students will sign up for specific dates to present their literature discussions (1-2 student presentations for each class session). 2. Final paper -70% A final paper will be required of each student. The paper will be a current literature review of a specific issue related to border health or security. The final paper should be double-spaced, under 10 pages in length, and include any relevant reference citations. Potential final paper subjects will be identified during initial class sessions. If desired, you may discuss your paper topic or obtain topic suggestions with either Dr. Stratton or Dr. Greenwood. Proper grammar, spelling, and format are expected. A discussion of bias, data sources used, level of intellectual input, and general applicability of the information presented should be the basis, but not the limit of the paragraph discussing the validity or reliability of each reference. The paper will be due during the final exam week of the quarter. 3. Class participation 10% CHS 440 is designed around a class discussion format. Directed and interactive

3 Page 3 discussions are used to develop topics and foundations of thought that are important to U.S.- Mexico border health. To allow for discussion of topics by all class members, the course enrollment is held strictly to a maximum of 15 students. The volume of words a student provides in class discussion is not as important as the content of statements and the thoughts presented. GENERAL STATEMENT ON GRADING AND ASSIGNMENTS It is assumed that as a graduate student one will receive a grade of A or B in this course. An A grade is achieved by doing exceptional work in the course and contributing not only to one s own education but also to the education of all those in the course (including the instructors). It is hard to get a C in the course but can be achieved by lack of class attendance, ongoing tardiness, and lack of interest in class participation, not reading course materials and not submitting written assignments that reveal a lack of attainment of the majority of the course goals. STATEMENT OF CAUTION AND APPEAL At all times, respect of others and a mature attitude is expected of all course participants. Some topics covered in the course are of sensitive ethnic, gender, religious, and political natures. It is extremely important that all class participants observe the rights of others to speak and express their opinion on any matter in open discussion. Students are encouraged to ask for an immediate break to speak to the instructor if the discussion in progress is personally disturbing or offensive. Please notify the instructor in person, by phone, or by if at any time the course is falling below your expectations or you feel the course should be re-directed.

4 CLASS SCHEDULE CHS 440: Border Public Health and Security Page 4 WEEK 1: Monday, September 28 Introduction and Course Overview Course overview What is a border? What crosses a border? Border security and terrorism Readings: 1. Southern Exposure, AARP The Relationship Between Remittances and Health Care Provision in Mexico, AJPH, July WEEK 2: Monday, October 5 Border Geography and Migration The geographic concept of borders Migration across borders Public policy implications at borders Government agencies US-Mexico Border Geography and Political History Human crossings along the U.S.-Mexico Border (Structured Class Discussion) Readings: 1. Immigration Nation. Foreign Affairs, Nov/Dec, Puro Border, The Border is the Place Where We Live, pages and Everything is going to Be Different, pages WEEK 3: Monday October 12 Natural Disasters and Borders WHO, PAHO, and NGOs Health, economic, and terrorism implications of cross border disasters Disaster Hazard Risk Assessment of the US-Mexico Border Flooding in Baja, Mexico (Structured Class Discussion) Readings: 1. History and Structure of the Pan American Health Organization 2. Overview of WHO 3. Non-government Organizations, WHO WEEK 4: Monday, October 19 Social Health Issues at the US-Mexico Border

5 Page 5 Social health differentials at the U.S.-Mexico border Terrorism implications of across border tensions and law enforcement The Missing Women of Juarez (Structured Class Discussion) Readings: 1. Trujillo, Slavery in the 21 st Century, Americas, April, Laurell, What Does Latin American Social Medicine Do When it Governs? The Case of the Mexico City Government, AJPH, A Fighting Chance, The Wilson Quarterly, Spring "New Mystery in Juarez", LA Times, Aug 9, Puro Border, May Our Daughters Come Home/Nuestra Hijas De Regreso A Casa, pg WEEK 5: Monday, October 26 Health Delivery Issues At the US-Mexico Border Health Differentials at the U.S.-Mexico Border Health Access at the U.S.-Mexico Border US-Mexico Health Differential Statistics The cost of providing health to immigrants in the U.S. (Structured class Discussion) Readings: 1. Mexican and Central American Immigrants in the United States: Health Care Access, Regents of the University of California and The Mexican Secretariat of Health (SSA), 2006 pages Drieson et al, Evaluating Medical Outreach Networks in the US-Mexico Border Region, Journal of Border Health 5:19-26 (2000) 2. Blendon et al, Disparities in Health: Perspectives of a Multi-Ethnic, Multi- Racial America, Health Affairs "Mexico Eases Ban on Drug Possession", WSJ, Aug 22, WEEK 6: Monday, November 2 General Population Health and Naturally Occurring Infections Overview of the problem- surveillance and reporting Environmental factors Migration and infections A Cultural Comparison of Health in Mexico and the U.S. Is health care a commodity? (Structured Class Discussion)

6 Page 6 Readings: 1. Spiegel, Yassi, Lessons from the Margins of Globalization: Appreciating the Cuban Health Paradox, JPHP, Jan Smith, Demographic Features and Cross-Border Contact Among Tuberculosis Cases in the San Diego County Baja California Border Region, Journal of Border Health 5:28-33 (2000) 3. Learning to Live with HIV/AIDS: Latin America and Caribbean, Science Mexico s General Health Law, Title 8, Chapter II (2005) 2. The Challenge of Global Health, Foreign Affairs, Jan/Feb, Puro Border Nothing to Declare: Welcome to Tijuana, pages WEEK 7: Monday, November 9 Pandemic Disease and the U.S.-Mexico Border (The H1N1 Experience) The World Health Organization concept of pandemic disease Borders and Pandemics Governmental approach to pandemics Epidemiological Review of the H1N1 Outbreak The spread of H1N1 in Mexico and North America (Structured Class Discussion) Readings: 1. Emergence of a Novel Swine-Origin Influenza A (H1N1) Virus in Humans, NEJM, June Lessons From Outbreaks of H1N1 Influenza, Ann Internal Med, May Use of Revised International Health Regulations during Influenza A (H1N1) Epidemic, 2009, Emerging Inf Dis, August "Border Braces", Las Cruces Sun-News, April 30, WEEK 8: Monday, November 16 Environmental Health and Natural Disasters at the U.S.-Mexico Border Transportation of hazardous materials and waste Natural Disasters Risks and Management Border water quality Environmental contamination lead Pesticide flow across borders Lead Poisoning of Children in El Paso and Juarez

7 Page 7 Readings: 1. U.S. Canal Project Raises Tensions on Mexico Border, Reuters NAFTA: Preamble and Chapter 1 (Objectives and General Definitions), U.S. Government Printing Office, Puro Border, The Place of Wilderness, pages WEEK 9: Monday, November 23 Foods and Materials Globalization of the food supply Inspection and surveillance Security implications Contaminated strawberries (Structured Class Discussion) Readings: 1. Handley MA, Hall C, Sanford E, et al, Globalization, Binational Communities and Imported Food Risks: Results of an Outbreak Investigation of Lead Poisoning in Monterey County, California Am J Public Health FDA Beyond Our Borders, FDA, December "Multistate Outbreak of Salmonella Infections Associated with Peanut Butter and Peanut Butter-Containing Products-United States, ", MMWR, Feb 6, Puro Border, Ropa Usada, page WEEK 10: Monday, November 30 Border Terrorism Issues Terrorism hazards along the U.S.-Mexico border: 1. What is the risk of terrorism along the U.S.-Mexican Border? 2. Ranking of terrorism risks 3. Identify agencies and groups responsible for terrorism risk assessment and mitigation at the borders Can a terrorist cross the border? (Structured Class Discussion) Readings: 1. O'Neil, "The Real War in Mexico", Foreign Affairs, July/August Hakim, Is Washington Losing Latin America?, Foreign Affairs, Jan/Feb, 2006 FINAL EXAM WEEK: Course Paper and Course Review Due